The prevalence of Type D personality and its association with clinical outcomes in patients with cervical radiculopathy after either conservative or surgical treatment

Type D personality, characterized by the combination of negative affectivity and social inhibition, has been associated with adverse outcomes in several patient populations, but its role in patients with cervical radiculopathy remains unknown. This study aimed to evaluate the association between baseline Type D personality and clinical outcomes over a 2 year follow-up period in patients with cervical radiculopathy treated with either conservative or surgical treatment. In addition, we explored baseline characteristics associated with the presence of a Type D personality. Data were derived from the CASINO trial (NTR3504), a prospective multicenter observational cohort study including patients with cervical radiculopathy due to disc herniation. Clinical outcomes included Visual Analog Scale (VAS) arm pain, VAS neck pain, Neck Disability Index (NDI), and EuroQol Visual Analog Scale (EQ-VAS), measured at baseline and during follow-up up to 104 weeks. Linear mixed-effects models were used to evaluate associations between Type D personality and longitudinal clinical outcomes, adjusted for baseline outcome values, age, gender, and BMI. A total of 141 patients were included (mean age 51.1 years; 52% female), of whom 88 (62%) underwent surgical treatment and 40 (28%) had a Type D personality. No significant differences in clinical outcomes were observed during short-term follow-up. Over the 2 year follow-up period, however, in the whole cohort, patients with a Type D personality reported higher VAS arm pain scores compared with patients without a Type D personality (β = 11.72, p = 0.030). Similarly, Type D personality was associated with higher NDI scores at 2 years (β = 7.63, p = 0.033). Furthermore, patients with a Type D personality reported lower EQ-VAS scores at 1 year, reflecting poorer overall perceived health (β = −10.51, p = 0.031). No significant association was observed between Type D personality and VAS neck pain. Baseline characteristics associated with Type D personality included a longer interval between symptom onset and first general practitioner consultation and a higher proportion of patients living alone or not married. Identification of Type D personality may contribute to improved patient counseling and long-term expectation management.